INDIANA DEPARTMENT OF ADMINISTRATION Prior Authorization & Utilization Management Services REQUEST FOR PROPOSAL on behalf of Office of Medicaid Policy and Planning

INDIANA DEPARTMENT OF ADMINISTRATION GENERAL INFORMATION Attendee Sign-In Sheet Sign-In Sheet and PowerPoint will be posted on State’s Solicitation Website

INDIANA DEPARTMENT OF ADMINISTRATION RFP QUESTIONS AND ANSWERS Questions answered verbally today are not official nor binding and should be submitted in writing if it will affect your proposal response (Q/A Template – Attachment I) All questions must be submitted in writing by 3:00 PM EST on April 19, Fax:

INDIANA DEPARTMENT OF ADMINISTRATION ACCESSING RFP DOCUMENTS

INDIANA DEPARTMENT OF ADMINISTRATION ACCESSING RFP Documents

INDIANA DEPARTMENT OF ADMINISTRATION KEY RFP DATES

INDIANA DEPARTMENT OF ADMINISTRATION PURPOSE AND SCOPE OF RFP The purpose of this RFP is to select a vendor that can satisfy the State’s need for Prior Authorization and Utilization Management services for IHCP enrollees excluding those enrolled in the managed care portion of the program. The PA function shall cover all products and services for which the State’s medical policy requires PA, except pharmacy services. Contractor will receive PA requests from providers via telephone, fax, web-based system or in writing and will process them in a timely manner, including interfacing with IndianaAIM. As part of the PA services, Contractor shall set up a PA call center and have in place other technologies such as faxes and web-based systems to accept PAs. Additionally, Contractor will be responsible for providing Utilization Management services, which include Reviews for Elective Inpatient Admissions, Traumatic Brain Injury Services, Peer Review Studies and Focused Studies.

INDIANA DEPARTMENT OF ADMINISTRATION RFP OUTLINE

INDIANA DEPARTMENT OF ADMINISTRATION BUSINESS PROPOSAL Company Financial Information (Section 2.3.3) Confidential information must be kept separate from the proposal in both hard and soft copy

INDIANA DEPARTMENT OF ADMINISTRATION COST PROPOSAL The cost proposal is comprised of sections for Prior Authorization, Utilization Management and Implementation respectively.

INDIANA DEPARTMENT OF ADMINISTRATION COST PROPOSAL (Cont.) The cost proposal is comprised of sections for Prior Authorization, Utilization Management and Implementation respectively.

INDIANA DEPARTMENT OF ADMINISTRATION MINORITY AND WOMEN’S BUSINESS ENTERPRISE Complete Attachment A, MWBE Form - Include sub-contractor letters of commitment Goals for this RFP: - 8% Minority Business Enterprise - 8% Women’s Business Enterprise

INDIANA DEPARTMENT OF ADMINISTRATION MINORITY AND WOMEN’S BUSINESS ENTERPRISE $$$$$ $

INDIANA DEPARTMENT OF ADMINISTRATION INDIANA ECONOMIC IMPACT The State defines FTE as a measurement of an employee's productivity on a specific project or contract. A FTE of 1 would mean that there is one (1) worker fully engaged on a project; forty (40) hours a week, fifty- two (52) weeks a year. If there are two (2) employees each spending 1/2 of their working time, 20 hours per week, on a project that would also equal 1. $$$$$ $

INDIANA DEPARTMENT OF ADMINISTRATION RFP SCORING AND EVALUATION

INDIANA DEPARTMENT OF ADMINISTRATION QUESTIONS AND ANSWERS

INDIANA DEPARTMENT OF ADMINISTRATION ADDITIONAL INFORMATION IDOA PROCUREMENT LINKS AND NUMBERS BUYIN (8946) For Vendor Registration Questions For Inquiries Regarding Substantial Indiana Economic Impact A.Link to the developing “one stop shop” for vendor registry with IDOA and Secretary of State. B.Secretary of State of Indiana: Can be reached at (317) for registration assistance. C.Vendor Handbook: Online version available at D.Minority and Women Owned Business Enterprises: for table of IDOA certified MBEs and WBEs. For more WBE’s information E.RFP posting and updates: Go to (select “State of Indiana Opportunities” link) Drag through table until you find desired RFP/RFI number on left-hand sidehttp:// and click the link.